Transcript PALLIATIVE CARE

PALLIATIVE CARE
An overview
DEFINING PALLIATIVE CARE
World Health Organisation
• “Palliative care is an approach to care that
improves the quality of life of patients and
their families facing problems associated
with life threatening illness, through the
prevention and relief of suffering by means
of early identification and impeccable
assessment and treatment of pain and
other problems, physical, psychological
and spiritual”.
DEFINING PALLIATIVE CARE
• Palliative care is:
….the active holistic care of patients with
advanced, progressive illness. Management of
pain and other symptoms and provision of
psychological, social and spiritual support is
paramount.
The goal of palliative care is
achievement of the best quality of life for
patients and their families. Many aspects of
palliative care are also applicable earlier in the
course of the illness in conjunction with other
treatments..(From NICE 2004 Improving Supportive and Palliative
Care for Adults with cancer)
PRINCIPLES
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Focus on quality rather than quantity of life
Life affirming but death accepting
Effective communication at all levels
Respect for autonomy and choice
Effective symptom management
Holistic, multi-professional approach
Caring about the person and those who
matter to that person
KEY ISSUES
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Information needs
Being treated as a human being
Empowerment
Physical needs
Continuity of care
Psychological needs
Social needs
Spiritual needs
WHOSE RESPONSIBILITY?
• It is the right of every person with a lifethreatening illness to receive appropriate
palliative care wherever they are
(DoH, 1998)
• Palliative care is the responsibility of all
health and social care professionals
delivering care
(NICE, 2004)
THE PALLIATIVE CARE
APPROACH
Delivered
by
the
patient’s
usual
professional carers as a vital and integral
part of their routine care delivery
• For patients with low to moderate
complexity of need
• Focuses on the key principles of palliative
care
(NCHSPCS, 2002)
SPECIALIST PALLIATIVE CARE
(SPC)
• SPC teams defined in terms of their core
service components, their functions and
team composition
• Provided for patients an families with
moderate to complex palliative care needs
• May be provided directly or indirectly
(NCHSPCS, 2002)
WHAT DOES THE SPECIALIST
PALLIATIVE CARE TEAM DO?
• Advise on management of symptoms
• Provide
information
on
diagnosis,
investigations and treatments
• Offer emotional, spiritual and social
support
• Liaise closely with the whole health team
with the aim of improving the patients
quality of life
• Offers support via education to healthcare
staff
MEMBERS OF THE PALLIATIVE
CARE TEAM
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Consultant in Palliative Medicine
3 Clinical Nurse Specialists
Clinical Specialist Occupational Therapist
Secretary
Clinical Specialist Dietician
Clinical Specialist Speech and Language
Therapist
• Pharmacist
WHO TO REFER
Referral to a Palliative Care Team
is appropriate for any patients
with an incurable, progressive
and fatal illness.
WHO TO REFER
Particularly recommended for:
• Patients with rapidly progressive disease
• Patients with disease presenting unexpected,
difficult to control, or rapidly progressing
symptoms
• Distressing symptoms, when no relief has
been achieved within 48 hours
• Psycho-social distress in patient or family
relating to the diagnosis or in facing death
• Where reassurance of a second opinion is
sought – by patient, family or other health
care professional
KEY MESSAGES:
Philosophy of Palliative Care
• Should be available to anybody with a life
threatening illness
• Focus of care is quality of life, with the
autonomy and choice of the patient being
upheld
• Care is extended to both the patient and
those who matter to him/her
• A whole system approach is made when
planning care with the patient
KEY MESSAGES:
Philosophy of Palliative Care
• Palliative care should be delivered by any
health/social care professional in care setting of
patient’s choosing
• Palliative care should begin at diagnosis of life
threatening condition, continuing through to
death/ bereavement
• Specialist Palliative Care is defined in terms of
core services, delivered using multi-professional
team with skills, knowledge and experience in
palliative care
• Specialist Palliative Care is needed by only a
minority of people with complex problems